High prevalence of anxiety and depression among patients hospitalized with acute febrile illness in Sri Lanka

IntroductionAcute febrile illnesses (AFI) such as dengue, leptospirosis, and influenza result in large numbers of hospitalization in the tropics. These illnesses may negatively impact patients mental health. We evaluated the prevalence of anxiety and depression and risk factors associated with these conditions in patients hospitalized with AFI. MethodologyFrom July-October 2017, we conducted a cross-sectional study of consecutive patients [≥]12 years admitted with AFI to a tertiary care hospital in Sri Lanka. We administered the Hospital Anxiety and Depression Scale (HADS) validated in the local language of Sinhala to identify the presence and severity of anxiety and depression. We identified the prevalence of anxiety and depression and determined the association with sociodemographic and clinical characteristics using Chi square and t-tests and multivariabele logistic regression. ResultsOf 193 enrolled, 44.6% were male. AFI included dengue (62.7%), viral fever (10.4%), urinary tract infection (6.2%), leptospirosis (4.7%), pneumonia (3.1%) and typhus (0.5%). Overall, 41.4% patients had anxiety and 42.5% had depression. On multivariable analysis, anxiety was associated with awareness of diagnosis (OR=4.3, CI 1.3-13.76, p=.03), lower satisfaction score (OR=0.73, CI 0.58-0.92, p=.008) and lower income (OR=1.92, CI 1.03-3.57, p=.03). Depression was associated with anorexia (OR=2.8, CI 1.33-5.87, p=.006) and diarrhea (OR=2.29, CI 1.17-4.47, p=.01). ConclusionsPatients hospitalized with AFI had a high prevalence of anxiety and depression. Gastrointestinal symptoms, lower socioeconomic status, and awareness of illness diagnosis were all associated with anxiety. Our findings may be helpful in developing interventions to counteract anxiety and depression among patients hospitalized with AFI.